go back

New Hampshire rates for HCPCS L0625

Lumbar Orthosis Flexible Provides Lumbar Support Posterior Extends From L-1 To Below L-5 Vertebra Produces Intracavitary Pressure To Reduce Load On The Intervertebral Discs Includes Straps Closures May Include Pendulous Abdomen Design Shoulder Straps Stays Prefabricated Offthe Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.47 / $36.47 / $43.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.18 / $28.30 / $36.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.67 / $41.67 / $49.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.19 / $36.19 / $37.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.15 / $38.15 / $42.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $32.43 / $42.22
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.44 / $52.44 / $161.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $32.31 / $38.36
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.70 / $51.24 / $75.31